Provider Demographics
NPI:1275003162
Name:SPORTS AND WELLNESS PHYSICAL THERAPIES
Entity Type:Organization
Organization Name:SPORTS AND WELLNESS PHYSICAL THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:RITSCHEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-202-7225
Mailing Address - Street 1:1 HEATHER DR
Mailing Address - Street 2:
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-3203
Mailing Address - Country:US
Mailing Address - Phone:973-202-7225
Mailing Address - Fax:973-585-6162
Practice Address - Street 1:1 HEATHER DR
Practice Address - Street 2:
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-3203
Practice Address - Country:US
Practice Address - Phone:973-202-7225
Practice Address - Fax:973-585-6162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-04
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ38MC00400200OtherNJ LICENSE